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October 6, 2020

Reminder: When to Submit a Corrected Notice of Termination/Revocation (NOTR)

CGS has seen situations where providers submit a Notice of Cancelation TOB 8XD to cancel an incorrect NOTR. Because the TOB 8XD removes the notice of election (NOE) (TOB 8XA) from the CWF, this will often require you to resubmit a new NOE, which will likely be untimely. Please have your billing staff review the following information.

NOTR Requirements

The Notice of Termination/Revocation (NOTR), Type of Bill (TOB) 8XB, is submitted when the hospice discharges the beneficiary, or the beneficiary chooses to revoke the Medicare Hospice Benefit if the hospice has not already filed a final claim. The NOTR (8XB) or final claim (8X4) must be filed within five days of the effective date the beneficiary is discharged or revoked.

While it is preferred that you file a final claim instead of a NOTR, if that final claim rejects or denies, submitting an NOTR will still be required in order to post the revocation on the Common Working File (CWF).

When to Submit a Corrected NOTR

A corrected NOTR should be submitted when an incorrect discharge/revocation (THROUGH) date was submitted. In the example below, the original NOTR was submitted with a FROM and ADMIT date of 09012020 and an incorrect THROUGH date of 09152020. This caused the revocation date of 09152020 to post to CWF. The correct THROUGH date is 09182020.

Note: Do not submit an 8XD to cancel the discharge/revocation notice (8XB).

Submit the following to correct the NOTR.

Type of Bill (TOB): 8XB
Statement Covers Period Enter 09012020 in the 'FROM' date field
Statement Covers Period Enter 09182020 (correct discharge date) in the 'THROUGH' date field.
Admission Date
  • If no change in the provider number has been made, the "FROM" date submitted on the NOTR will match the effective election date
  • If the revocation/discharge date follows a transfer, the "FROM" date on the NOTR must match the "START DATE 2" on the benefit period that initiated the transfer
Condition Code Enter D0 (ensure that the number zero is entered)
Occurrence Code and Date Enter Occurrence Code 56 and 09152020 (incorrect discharge date)

When an NOTR is Submitted in Error

When an NOTR is submitted entirely in error (e.g., the beneficiary actually transferred to another hospice, rather than revoking the hospice benefit), a revocation date is incorrectly posted to CWF. Hospice providers may remove a revocation date established from an NOTR submitted in error.

In the example below, an NOTR was submitted with a FROM and ADMIT date of 09012020 and THROUGH date of 09182020; therefore, the revocation date of 09182020 was posted to CWF. Rather than the beneficiary being discharged/revoked, they actually transferred to another hospice on 09182020.

Follow the steps below to remove the incorrect revocation date from CWF.

Type of Bill (TOB): 8XB
Statement Covers Period Enter 09012020 in the 'FROM' date field
Statement Covers Period Enter 000000 in the 'THROUGH' date field (all zeros).
Admission Date
  • If no change in the provider number has been made, the "FROM" date submitted on the NOTR will match the effective election date
  • If the revocation/discharge date follows a transfer, the "FROM" date on the NOTR must match the "START DATE 2" on the benefit period that initiated the transfer
Condition Code Enter D0 (ensure that the number zero is entered)
Occurrence Code and Date Enter Occurrence Code 56 and 09182020 (incorrect discharge date)

If the final claim (TOB 8X4) was submitted and created a revocation date on CWF, the final claim would need to be cancelled. The above NOTR instructions would not remove the revocation date.

Note: The correction NOTR must be entered via DDE. This direction is for NOTRs submitted in error for discharge dates that occurred on or after January 1, 2018. Zeros in the "Through" date are not allowed in the 837I transaction (electronic submission). DDE is not an electronic submission.

Refer to the following resources for additional information and billing instructions for the different Hospice TOBs.

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